充气式止血器不同加压时长对桡动脉入路冠脉造影术后护理效果的影响

Effect of inflation tourniquet with different compression time on the postoperative care outcome of coronary angiography access of radial artery

目的通过对比充气式止血器不同加压时长对桡动脉入路冠状动脉造影术后止血效果的影响,找出相对方便有效的止血时间和方法,以期尽量减少局部血管并发症的发生,减轻患者不适。方法采用随机对照的临床试验方法,结合随机信封和随机序列号进行分组,根据纳入标准分别纳入试验组50例和对照组50例。试验组术后1h开始减压,首次放气2mL,之后每隔1h放气3mL,放气完毕后观察0.5h。对照组术后2h开始减压,首次放气2mL,之后每隔1h放气2mL,放气完毕后观察0.5h。观察记录两组受试者局部血管并发症的发生情况及患者的舒适度。结果试验组和对照组在局部并发症的发生上差异有统计学意义(χ~2=4.56,P=0.03<0.05),术后舒适度差异有统计学意义(t=5.43,P=0.00<0.05)。结论缩短加压止血器压迫时间,加大每次间隔放气量,在对患者无明显负性影响的基础上,减轻了患者因受压时间过长而出现的恐惧、烦躁、焦虑等一系列不适反应,降低了术肢麻痹、疼痛等局部血管并发症的发生,减轻了对患者进食与休息的影响,增加了患者的舒适度,同时避免了患者频繁呼叫医护人员,提高了护理临床工作效率,值得临床推广使用。

Objective To observe the clinical effect of inflation tourniquet with different compression time on the postoperative care outcome of coronary angiography access of radial artery,and find a relatively convenient and effective time and method of hemostasis to minimize the occurrence of local vascular complications and reduce the discomfort of the patients.Methods Adopting a randomized controlled clinical trial and grouping with random envelopes and random sequence numbers,50cases of experimental group and50cases of control group were selected according to inclusion criteria.At1h after operation began to decompress in the experimental group,2mL of the first draft,then every1h deflated3mL,and observation for0.5h after air release.At2h after operation began to decompress in the control group,2mL of the first draft,then every1h deflated2mL,and observation for0.5h after air release.The occurrence of local vascular complications and the comfort of the patients between two groups were compared.Results Local complication rate between two groups showed significant difference(χ2=4.56,P=0.03<0.05).The comfort of the patients between two groups between two groups showed significant difference(t=5.43,P=0.00<0.05).Conclusion On the basis of no significant negative effects on the patient,shorten the compression time of the pressurized hemostat and increase the air discharge at each interval reduces the patients because of long duration of compression and the emergence of fear,irritability,anxiety and discomfort of a series,lower limb paralysis,pain and local vascular complications,reduce the impact on patients with eating and rest,increase patient comfort,while avoiding the patients frequently call medical personnel,improve the the clinical nursing work efficiency,worthy of clinical promotion.